TREATMENT INVOLVING THE “SOCIAL ENGAGEMENT PROTOCOL”

The following is my summary of a workshop I attended led by Steven Porges, in May of 2003, at the Rosenberg Institute in Copenhagen.  

   A cat catches a mouse.  Suddenly the mouse appears to freeze, seemingly dead. The cat may toy with the rodent a while, eventually loses interest, wanders off.  Before long, the mouse miraculously revives, and scuttles away.

   This scenario is called “death feigning,” and is a last resort survival mechanism, when ‘fight or flight’ has not sufficed.  It is an actual physiological state, where the mouse loses consciousness, its heart rate slows almost to a stop, and its breathing all but ceases.  It demonstrates the most primitive, and lowest level of being in mammals, where one is still alive.

 THE LEVELS:

 According to a new perspective by Stephen Porges,* as presented in his Polyvagal Theory in 1995,  we mammals have basically three {physiological) states of being—stances if you will—arranged in the following hierarchy:

   1. Social engagement (at ease, creative) 

   2. Fight or flight (stress, mobilization)

   3. Shut down: depression, “death feigning.” (immobilization) 

   Each of these levels is part of our make-up by nature, with one main purpose: our survival.  Therefore each will be appropriate at different times and in different situations. His theory, oversimplified, says we play our “best card first,” (Social Engagement), and if that doesn’t work, our “next best card,” (Fight or Flight).  Only if these fail, do we resort to our “last card,” (Shut down).  The healthy individual will be able to move freely among these states as is appropriate.  However: we sometimes get stuck.  

   In the United States, stress is widespread and common.  Whether it be anxiety, post traumatic stress disorder (PTSD), or chronic stress, one end result of stress is difficulty not only in communicating, but also in relating, making social bonds, and being loving in general.   In Denmark, it has been estimated that 50% of the  population is stuck in chronic stress (level 2 above), and 10-15%, in depression (level 3).*  These people need help to regain flexibility to reach the social engagement level.  This help may include changing one’s situation, seeking psychological or medical attention, meditative l techniques, relaxation exercises, and more.

    But let us first examine some of the characteristics of each state.

   In the highest, and in general the most desirable level (social engagement), we feel safe, we communicate freely and spontaneously to others, we look at them, especially their faces, and make eye contact, our voices exhibit prosody (modulation, melodic and dynamic variety), and we listen comfortably and easily understand as they speak, or respond.  We will turn our head freely to interact with others, and our faces will be alive with writemyessayfast expression.   Loving and social bonding become possible.  Our physiology will be in balance, and our sympathetic (stimulatory) and parasympathetic (inhibitory) branches of our autonomic nervous system will be functioning harmoniously, but enhancing a low or moderate expenditure of energy.

   If we feel in danger or stressed, we will likely move down to the level called fight or flight, which is a mobilized condition.  In the animal kingdom, this state of being is appropriate and necessary in situations where one is threatened, or in danger of attack, and needs to either defend oneself, or flee.  The parasympathetic and sympathetic branches now cooperate to promote a high expenditure of energy:  Blood flow to the brain stem is decreased, thereby making more blood available to the skeletal muscles.  Digestion is shut down, the heart rate increases, adrenalin is released, and bronchioles dilate to provide more oxygen.  Blood vessels of certain organs–skin, viscera—constrict to save energy, while others–skeletal muscles, lungs, & heart–dilate to provide more energy. We are ready for battle or escape.

   Should level two behavior not be possible, or fail, we resort to the lowest–and rarest–level of  functioning, and go into a sort of “shut down” syndrome. (Refer to the cat and mouse scenario above). Humans typically exhibit somewhat less dramatic symptoms of withdrawal, depression, shock, lethargy, and immobilization. 

 PHYSIOLOGY OF THE SOCIAL ENGAGEMENT LEVEL:

   According to Porges, the cranial nerves (CN) V, VII, IX, X, XI are the controllers of our social engagement system.  They provide motor and/or sensory connections to various areas: muscles of the middle ear, mastication, facial expression, larynx, pharynx, heart, bronchi, and muscles which turn the head.  All these muscles and organs make up our highly developed communication equipment. 

   A few examples will elaborate: The muscles of the middle ear (served by CN V) dampen low frequencies to facilitate hearing the frequencies of speech.  Certain  facial muscles near the eyes (CN VII) produce tiny movements 20 times a second, which are subconsciously read by the listener.  Head turning (CN XI) is essential for communicating in groups.

   Problems arise when pathways of these nerves, or associated blood supply, are interrupted by trauma or stress. This may be anywhere along the pathways, but is especially critical in two areas: At the atlanto occipital joint (between the skull and the first vertebra), and at the jugular foramen–a pea-sized aperture between the skull and neck. 

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EXAMPLES OF A TECHNIQUE FROM THE PROTOCOL:

   The following is an example of the technique for the atlanto-occipital joint, taken from Rosenberg’s Social engagement protocol.  I reword, and omit, some parts of the technique, for clarity and simplicity.

   With the client on his back, check the position of C1 (first vertebra) with a light touch of the end of your thumb on the connective tissue over C1, just medial to the sternocleidomastoid muscle.  If C2 is rotated it can hinder the circulation of blood to the brain stem, reducing the flow to the cranial nerves V, VII, IX, X, and XI.  Which side of the head is the transverse process of the vertebra more forward?  On this side, there will be tension in the rectus capitus posterior minor (a muscle deep in the back of the neck).  Release this muscle by lightly stretching the skin over it in opposite directions with your two index fingers.  (See arrows at “1” in the diagram.)  Next release the rectus capitus posterior major muscle with a direct pressure inward.  Finally, find the tender area of the superior oblique muscle under the edge of the occiput.  Hold pressure on this area, and have the client ‘wave goodbye’ to the tension with movement at the wrist on the same side of his body.   

   Other techniques from the protocol include: Expanding the foramen magnum.  Opening the joint between the foramen magnum and C1.  Treating acupuncture points S5 and S6.  Opening the jugular foramen.  And ten additional techniques.

 CONCLUSION

   According to Rosenberg, treatments with the social engagement protocol leaves one in a state free of stress, and more able to communicate comfortably and spontaneously.  The purpose of the protocol is not to lock a person into the social engagement level, but rather:

  1. To free those who are ‘stuck’ in a level of stress or depression.
  2. To improve one’s ability to move freely, according to circumstances, to the appropriate level of behavior.

 *Stephen Porges, Director Brain-Body Center, University of Illinois, Chicago.   www.stephenporges.info

 *Stanley Rosenberg, Director, Rosenberg Institute, Silkeborg Denmark   www.stanleyrosenberg.com